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Enhancing decision-making and patient comprehension in complex rectal cancer surgery through personalized
Jordan A Fletcher1,2,3, Alison Corr1,2,3, Ioanna Drami1,2,3
1Complex Cancer Clinic, St Mark's - The National Bowel Hospital, London, UK.
The British Journal of Surgery
|June 27, 2025
Summary
Personalized 3D models significantly reduced decisional conflict and improved patient understanding for complex rectal cancer surgery. This approach enhanced patient-surgeon agreement on outcomes, aiding shared decision-making.
Area of Science:
- Oncology
- Surgical Innovation
- Patient Education
Background:
- Shared decision-making is crucial for patients undergoing complex rectal cancer surgery (pelvic exenteration).
- Patients often struggle with understanding procedures and risks, leading to decisional conflict.
- Personalized 3D models offer a potential solution to improve patient comprehension and decision-making.
Purpose of the Study:
- To assess the feasibility of using personalized 3D models in patient consultations for pelvic exenteration.
- To evaluate the impact of 3D models on patient understanding, decisional conflict, and patient-surgeon agreement.
Main Methods:
- A mixed-methods randomized feasibility trial comparing standard consultation with 3D model-assisted consultation.
- Patients were randomized 1:1 to either group.
- Outcomes included qualitative interviews on engagement, decisional conflict scale (DCS) scores, operative knowledge, and patient-surgeon agreement.
Main Results:
- 3D models improved patient understanding, trust, and communication.
- The 3D group showed a significantly greater reduction in decisional conflict scale scores (36 vs. 14 points).
- Higher patient-surgeon agreement on functional outcomes was observed in the 3D group (84% vs. 60%), despite increased operative complexity.
Conclusions:
- Personalized 3D models show promise in enhancing comprehension and reducing decisional conflict for rectal cancer patients.
- Further research is needed to address baseline differences and explore long-term outcomes like decisional regret.
